Telangana: Fewer Covid tests lead to drop in cases; govt says focusing on treatment

After Telangana recorded its highest single-day spike of 10,122 on April 26, the daily number of positive cases has been on a decline. As much as this brings some respite from the alarm that the spike had caused, the fact is that the number of tests conducted across the state has dropped considerably ever since. However, COVID-19 fatalities have marginally risen and the test positivity rate has remained more or less the same.

Telangana has been witnessing a surge in coronavirus cases since the second week of March and the health department had warned, at that time, of a surge for the next four to six weeks. The state also imposed a night curfew between 9 pm and 5 am from April 20 and the same was extended later till the wee hours of May 8.

Between April 20 and May 3, a total of 1,02,002 new infections were added to the state’s caseload taking the cumulative figures to date to 463,361. As the caseload jumped about 28 percent in 13 days, as many as 620 COVID fatalities have been recorded officially taking the cumulative number to 2,476. That is, about 25 percent of the total COVID fatalities in the state recorded since March 2020 have been recorded in the last 13 days.

During the same period, the daily test positivity rate rose from 5.28 percent on April 20 to 10.25 percent on May 3. The highest daily TPR was recorded on the same day the state reported the highest single-day spike. As many as 99,638 tests were conducted that day though the results of 5,474 were awaited. The number of tests dropped to 82,270 on April 27, 80181 on April 28, 77,091 on April 29, 77930 on April 30, 76,330 on May 1, 58,742 on May 2, and to 70,961 on May 3.

Simultaneously, the number of new infections dropped from 10,122 on April 26 to 8061 on April 27, 7994 on April 28, 7,646 on April 29, 7,754 on April 30, 7,430 on May 1, 5,695 on May 2, and to 6,876 on May 3. On all these days, the TPR hovered between 10 and 11 percent. The Telangana Health Department has reiterated multiple times that there was a shortage of testing kits and hence the drop in the number of tests.

A change in strategy

The director of Public Health and Family Welfare, Dr. G Srinivasa Rao, told indianexpress.com on Tuesday that the department’s focus is on ensuring timely treatment and not on testing anymore. “That is our strategy. (We are) pushing for treatment first, where we can save lives instead of wasting time and resources in testing as RT-PCR results would take two or three days. By then, the patient loses valuable time,” he said.

Explaining further, he said, “You need to understand that we are passing through a pandemic. Testing is not the priority at the moment, treatment is the priority. If someone is having flu-like or COVID-like symptoms, and when you test them they turn positive. What is the necessity of doing a test when you can start treatment instead.”

Dr. Rao stressed that the duration between the 5th to 8th day after contracting the virus is very critical. “Now we are focusing on OP services in all our health facilities. We have started outreach services. Our focus is on treatment.”

When asked if fewer tests would lead to underreporting of cases, he said: “When I am taking every symptomatic person as positive for COVID, where is the question of (underreporting) numbers.”

So such out-patients would be added to the cumulative caseload? “Obviously,” he stated.

‘Start treatment, but testing is necessary’

Welcoming the government’s decision, Dr. K Mahesh Kumar, president of the Healthcare Reforms Doctors’ Association (HRDA), pointed out that flu-like symptoms are uncommon during summer. “Generally we don’t see symptoms like sore throat, runny nose, high-grade fever, and cough, etc. If one displays such symptoms it is better to start early-stage treatment for COVID. No need to wait for the test report,” he said, adding “they still have to get tested but do not have to wait for the report for starting treatment.

Though the daily Test Positivity Rate (TPR) in the state has remained between 10 and 11 percent in the last 8 days, it is too early to suggest plateauing, said Professor Subodh Kandamuthan, the director of the Centre for Health Care Management at Administrative Staff College of India. (PTI)

The number of active patients in the cumulative caseload has gone up from 46,488 on April 20 to 79,520 as of May 3. Chief Secretary Somesh Kumar on May 2 directed the opening of out-patient services at all government hospitals, urban health centres, and Basthi Dawakhanas in the city. Anyone with a COVID-like symptom can walk in and avail of treatment as well as collect a home-treatment kit, according to an official release.

Meanwhile, he directed officials to constitute teams of municipal staff, ANMs (auxiliary nursing midwifery), and at least two ASHAs (Accredited Social Health Activists) to visit households in their areas to identify people with fever and other symptoms, hand over medical kits, follow up and monitor their health.

According to the Greater Hyderabad Municipal Corporation, as many as 641 such teams visited 40,000 homes as part of a fever survey on Tuesday and identified 1,487 persons with flu-like symptoms. Besides, 18,600 people with symptoms were tested for COVID as out-patients at health centers. About 3,600 persons were diagnosed with the disease and handed over COVID kits.

‘Too early to suggest plateauing, should not lose guard’

Though the daily Test Positivity Rate (TPR) in the state has remained between 10 and 11 percent in the last 8 days, it is too early to suggest plateauing, said Professor Subodh Kandamuthan, the director of the Centre for Health Care Management at Administrative Staff College of India, who noted that Telangana did not witness abnormal peaking even during the first wave last year. “The WHO is clear that TPR above 5 percent is dangerous. Cases have been rising since mid-March. Whether we reach a plateau or not, we have to be alert since our TPR is above 10 percent,” he said.

“I think we should not drop guard for the next two or three weeks. If the death rate and positivity rate continue to go up while the recovery rate falls, then we have a problem,” he added. The daily health bulletin reported 59 deaths on Monday, the highest ever for the state since the beginning of the pandemic. In the last 8 days alone, as many as 434 COVID fatalities were officially reported.

In another welcome change, the Director of Public Health on Tuesday issued a new notification directing all private hospitals treating COVID patients to admit only patients with moderate and severe symptoms. Mild and asymptomatic patients with oxygen saturation levels above 94 percent have been recommended home or institutional isolation. The hospitals have been asked not to insist on a COVID positive report for admission and display at the entrance itself a board with updated details on the availability of beds. “Many mild cases are unnecessarily admitted in hospitals and blocking beds. Strict guidelines and their implementation will reduce the burden on hospitals,” said Dr. Mahesh Kumar.